Addressing the challenge of covering heath care expenses—while minimizing economic risks. Moral hazard—the tendency to change behavior when the cost of that behavior will be borne by others—is a particularly tricky question when considering health care. Kenneth J. Arrow’s seminal 1963 paper on this topic (included in this volume) was one of the first to explore the implication of moral hazard for health care, and Amy Finkelstein—recognized as one of the world’s foremost experts on the topic—here examines this issue in the context of contemporary American health care policy. Drawing on research from both the original RAND Health Insurance Experiment and her own research, including a 2008 Health Insurance Experiment in Oregon, Finkelstein presents compelling evidence that health insurance does indeed affect medical spending and encourages policy solutions that acknowledge and account for this. The volume also features commentaries and insights from other renowned economists, including an introduction by Joseph P. Newhouse that provides context for the discussion, a commentary from Jonathan Gruber that considers provider-side moral hazard, and reflections from Joseph E. Stiglitz and Kenneth J. Arrow. “Reads like a fireside chat among a group of distinguished, articulate health economists.” —Choice

Seminar paper from the year 2014 in the subject Business economics - Economic Policy, grade: 1,3, University of Kassel, language: English, abstract: Within the discussion about the increasing expenditures in health insurance, the overutilization of medical care is often attributed to the existence of a moral hazard problem. Since moral hazard has a great impact on health insurance policies, there is a growing interest in the economic literature to identify and to measure its effects. Although the problem of overconsumption of medical care does not mean moral hazard per se, the determination of the latter may reduce its scope and help to mitigate the problem of overutilization. The main objective of this paper is an empirical evidence of the moral hazard phenomenon. By analysing the economic literature on moral hazard in health insurance this paper seeks for examples of its empirical evidence, whereby the emphasis lies on distinguishing between the demand-oriented (especially ex-post) and the supply-oriented (external) moral hazard.

Seminar paper from the year 2016 in the subject Business economics - Banking, Stock Exchanges, Insurance, Accounting, grade: 1,3, University of Kassel, language: English, abstract: In the discussion about cost increase for German health care, the existence of a moral hazard problem is often mentioned. A bigger part of the costs are ascribed to the insured persons ́ behavior or lifestyle. The insured person is led to an increased demand of medical services than without an insurance. But also doctors or pharmacists may be evidenced „unethical“ behavior on the part of supply-induced demand. Is it really an unethical or rather a rational behavior? Which experiences have been made with a higher self-participation of the insured people? In which context stay health care services and price elasticity? And how can you reduce the problem of moral hazard? These are just a few questions which will be examined in this paper. The first chapter begins with health insurance in general and explains the benefits and the risks of being insured. The second chapter gives a generally valid definition of moral hazard as well as in terms of health insurance in particular. The third chapter shows the empirical perspective from the point of view of insured people and doctors. Thereby, it will enlarge on the RAND experiment and the price elasticity in the German market. The fourth chapter gives a few solutions for moral hazard effects, whereby solutions for insured people and for alternative financing are here in the focus. The last chapter will give a conclusion to the discussed topic.

Why do people buy health insurance? Conventional theory holds that people purchase insurance because they prefer the certainty of paying a small premium to the risk of getting sick and paying a large medical bill. This book presents a new theory of consumer demand for health insurance. It holds that people purchase insurance to obtain additional "income" when they become ill.

Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.

Choosing economically optimal health insurance coverage involves a trade-off between risk reduction and the overuse of health care. The economic purpose of insurance is to reduce financial uncertainty or risk - the more health insurance lowers the risk, the greater will be the increase in social well-being. But increases in health insurance also increase the amount of medical care demand, because insurance lowers the out-of-pocket cost of health care - the larger the demand response of medical care to cost sharing, the greater the decrease in social well-being, due to the purchase of too much health care. This study examines this trade-off empirically by estimating both the demand for health insurance and the demand for health services. It relies on data from a randomized controlled trial of the cost sharing's effects on the use of health services and on the health status for a general, nonelderly (under age 65) population.

Over the past twenty years, many low- and middle-income countries have experimented with health insurance options. While their plans have varied widely in scale and ambition, their goals are the same: to make health services more affordable through the use of public subsidies while also moving care providers partially or fully into competitive markets. Until now, however, we have known little about the actual effects of these dramatic policy changes. Understanding the impact of health insurance-based care is key to the public policy debate of whether to extend insurance to low-income populationsand if so, how to do itor to serve them through other means.

Basic economic theory suggests that health insurance coverage may cause a reduction in prevention activities, but empirical studies have yet to provide much evidence to support this prediction. However, in other insurance contexts that involve adverse health events, evidence of ex ante moral hazard is more consistent. In this paper, we extend the analysis of the effect of health insurance on health behaviors by allowing for the possibility that health insurance has a direct (ex ante moral hazard) and indirect effect on health behaviors. The indirect effect works through changes in health promotion information and the probability of illness that may be a byproduct of insurance-induced greater contact with medical professionals. We identify these two effects and in doing so identify the pure ex ante moral hazard effect. This study exploits the plausibly exogenous variation in health insurance as a result of obtaining Medicare coverage at age 65. We find evidence that obtaining health insurance reduces prevention and increases unhealthy behaviors among elderly men. We also find evidence that physician counseling is successful in changing health behaviors.

This book presents an in-depth review on the role of health care financing in improving access for low-income populations to needed care, protecting them from the impoverishing effects of illness, and addressing the important issues of social exclusion in government financed programs.

Individuals with health insurance use more health care. One reason is that health care is cheaper for the insured. Additionally, having insurance can encourage unhealthy behavior via moral hazard. Previous work studying the effect of health insurance on medical utilization has mostly ignored behavioral changes due to having health insurance, and how that in turn affects medical utilization. This paper investigates the structural causal relationships among health insurance status, health behavior, and medical utilization theoretically and empirically, and separates price effects from behavioral moral hazard effects. Also distinguished are the extensive versus intensive margins of insurance effects on behavior.